A crucial aspect of contemporary dental implant research is modifying implant microdesign to achieve early and robust osseointegration. This study describes a new facile subtraction approach for microdesign modification of titanium implants using akali-hydrothermal followed by ion-exchange reaction (AHIE) in a salt solution, and compares osseointegration performance to machined titanium alloy (negative control) implants. The morphology, wettability, and roughness of the implant surfaces were evaluated. Twenty-four cylinders (two types/side) were inserted into the right and left mandibles of six Bengal goats in opposite order. The implant-bone interface was examined at 8 and 16 weeks following implantation using radiography, micro-computed tomography, histology, and scanning electron microscopy. After AHIE treatment, average surface roughness increased marginally (p > 0.05) due to predominantly micron-scale with random nano-scale alterations, whereas wettability improved substantially (p < 0.05). In addition to micro/nano-scale defects, the AHIE treatment produced few honeycomb-like surface patterns. The AHIE implants demonstrated early and direct bone to implant body contact, and achieved stronger bone fixation in vivo than machined implants. Based on laboratory and in vivo data, we conclude that AHIE processing of titanium implants may be a promising technique for improving surface quality while assuring secure and effective osseointegration for dental implant.
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